Kansas health officials are urging swimmers to take extra care in warm freshwater, which could be home to millions of microscopic killers.

A 9-year-old Johnson County girl is the latest victim of Naegleria fowleri, a brain-eating amoeba that lurks in warm, standing water. The girl died July 9 from primary amoebic meningoencephalitis, an extremely rare but almost invariably fatal brain infection.

“We are very saddened to learn of this unfortunate circumstance, and our thoughts and prayers are with the family and friends during this difficult time,” state health officer Dr. Robert Moser said in a statement. “It is important for the public to know that infections like these are extremely rare and there are precautions one can take to lower their risk – such as nose plugs.”

Naegleria fowleri enters the body through the nose, causing a severe frontal headache, fever, nausea and vomiting, according to the U.S. Centers for Disease Control and Prevention. Early symptoms give way to seizures, confusion and hallucinations as the amoeba migrates through the nasal cavity to the brain.

“After the start of symptoms, the disease progresses rapidly and usually causes death within about five days,” the CDC website reads.

Of 132 people infected with Naegleria fowleri in the United States between 1962 and 2013, only three have survived, according to the CDC. One survivor, a 12-year-old girl infected in 2013, was diagnosed early and treated with “therapeutic hypothermia” and the experimental drug miltefosine.

“Her recovery has been attributed to early diagnosis and treatment,” the CDC website reads.

But spotting the signs of the infection is tricky, because tests to detect the rare infection are “available in only a few laboratories in the United States,” according to the CDC.

“Because of the rarity of the infection and difficulty in initial detection, about 75 percent of diagnoses are made after the death of the patient,” the agency’s website reads.

The infection is most common in 15 southern-tier states, “with more than half of all infections occurring in Texas and Florida,” the CDC’s website reads.
Three-quarters of all U.S. cases have been linked to swimming in freshwater lakes and rivers, but infections have also been associated with slip-n-slides, bathtubs and neti pots, according to the agency.

The infection is not contagious and can’t be contracted from a properly chlorinated pool or saltwater, according to the CDC.

The agency recommends the following tips for summer swimmers:

- Avoid getting water up your nose by holding your nose shut, using nose clips or keeping your head above water when swimming or splashing in warm freshwater.

- Avoid submerging your head in hot springs and other untreated thermal waters.